From Blister to Sepsis

Last fall when I ran the Chicago Marathon, I got a blister on my little toe. The poor guy was pretty mangled and bloody by the time I finished the race, and I got it cleaned up in the medical tent and went on my way. While it hadn’t bothered me during the race, it was enormously painful after. I kept a blister block bandage on it to cushion it a bit, but by the Thursday following the race, it was so painful that it kept me awake at night. Since I had to work that Friday, I figured I’d go to the doctor Saturday morning and get it checked out. I thought it was a simple infection and some antibiotics would clear it right up.

As I was sitting in the doctor’s office that Saturday morning waiting for them to write my prescription, I got very nauseous and cold. I figured I just needed to get home and lie down, so I took my prescription and went on my way. The 5 mile drive home was excruciating. Every time I pressed the clutch with my left foot (where the infected toe was), I cried out in pain. I’m usually pretty tolerant to pain, but this was intolerable. I was also shaking all over–not trembling, but a more jarring shaking–and shivering with cold. I also had shooting pain running through my whole body. Similar to serious muscle soreness–that lactic acid buildup kind of soreness–the pain was everywhere. I somehow made it home and stumbled inside to the couch where I immediately covered myself with a blanket and continued to shake and shiver. I remember that I was freezing and in so much pain that I was moaning aloud (and not for dramatic effect for, well, no one, since I was alone). I called my mom and told her something was wrong. I’m not even sure what I said, but without asking any questions, she told me to hang up and dial 911. She later told me that I was barely coherent.

The firetruck arrived first, where a whole lot of firemen took my vitals until the ambulance arrived. My temperature was 96–almost 3 full degrees lower than usual–and my blood pressure was very low. The ride to the hospital felt endless, and even though the EMT was nice and trying to keep me talking, I couldn’t even keep my eyes open. At one point, I remember hearing the driver talking to the ER and saying we’d be there in 7 minutes. It sounded like a very long time to wait.

In the ER, I was immediately tested for sepsis, and the tests were positive. My lactic acid levels were more than 3 times the normal rate, my body temperature remained low, and I was in excruciating pain. I was given morphine, but after an hour, the pain returned and they gave me a stronger med to help take the edge off. While the pain throughout my body was horrible, my toe was the worst. It felt like it was going to ignite, and at that point, I would have happily had them cut it off just to take away the pain. It was intense and scary.

Several hours later, as they were getting ready to discharge me and send me home, I finally got up to go to the bathroom. It was only 10 feet away, but I was dizzy and incredibly nauseous just from the short walk. When I told the doctor, he threw away my discharge papers and told me I would be admitted–probably just for a night or two–to be monitored. My blood pressure was too low for them to take me to a room right away, so they kept giving me IV fluids until it came up enough to be considered stable.

I wound up staying in the oncology unit (because there’s no infectious diseases unit . . . ) for the next 5 nights. I was given a high volume of IV fluids to keep my blood pressure up and wound up getting fluid in my lungs from all the excess which resulted in pneumonia. I also had a lot of antibiotics and dilaudid (a narcotic) for my pain. It made me extremely itchy and between that and the infection in my blood, I developed an uncomfortable rash all over my abdomen and back. I was also in a really awesome <sarcasm> bed to prevent bedsores that moved on its own every 55 seconds. Every 55 seconds for 5 whole days. Not conducive to resting at all.

That’s the reader’s digest version so if it’s TL;DR for you, no worries. I’m sure the 4 of you who are interested enough in reading this blog will deal 😉 But I needed to recount this to remind myself that I was really sick. The mortality rate for septic shock is 40-60%. There was a serious chance I was going to lose my toe. I had to have a cannula because I couldn’t get enough oxygen on my own, and when I went to a cardiologist for my follow up appointment, he was shocked that I hadn’t been in intensive care. I tend to diminish things, but looking back on this objectively, I can see that it was very serious, and I need to recognize that training hard for another marathon just 3 months later might not have been in my best interest.

Can I run a marathon now? I’m sure I can. Will it be a PR and a representation of me at my strongest and best? Maybe not. Once you’ve had sepsis, your chances for death, even in the years that follow your recovery, are higher because of the toll it takes on your immune system. So for me to think that I’d be back at 100% within 3 months was probably a bit ambitious. But now I know, and I’ll try to go a little easier on myself. I’m still going to continue training (which went fine last week) and try my hardest, but I’m also going to be realistic and honest with myself about what my body can do. It’s just a race, and being healthy is more important than any race ever will be.